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General NPI Number Information
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NPI Number | 1265557151
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Entity Type | Organization
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Legal Business Name | JOSEPH P. LALKA MD PC
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 09/25/2007
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Provider Practice Location Address
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Address Line | 29 JONES AVE CHATHAM MEDICAL BUILDING
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City | CHATHAM
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State | NY
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Zip | 12037-1136
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Country | US
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Telephone | 518-392-1122
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Fax |
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Provider Business Mailing Address
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Address Line | 1556 STATE ROUTE 203
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City | CHATHAM
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State | NY
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Zip | 12037-1708
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Country | US
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Telephone | 518-392-2499
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH P. LALKA
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Credential | MD
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Telephone | 518-392-1122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 47307
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 139020
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License Number State | NY
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